5049.0: Wednesday, November 15, 2000 - Board 1

Abstract #11244

Decentralizing health services at the provincial level in Indonesia: Changes from recent legislation

John Chalker, MB, ChB, MSc, Management Sciences for Health, 165 Allandale Rd, Boston, MA 02130, 617-524-7799, development@msh.org

Historically, health services, health manpower, and the purchase of drugs and supplies in Indonesia have been centrally planned, financed, and supervised. The relationship between the central Department of Health (DepKes) and the National Development Planning Body (BAPPENAS) in relation to the provinces has been slowly changing. Over the past 10 years some functions have been devolved to the provincial level and some functions delegated to provincial offices which are arms of the MOH. At the provincial level, the power of BAPPENAS has historically been quite significant. Recent legislation is changing all these relationships. New laws devolve the responsibility for health services to the district level, in essence bypassing the provincial level. From this point onward district health offices will have the responsibility to hire and fire, to compete for health resources, and to provide health services under the direction of local district parliament. These changes are requiring the MOH to rethink the roles of all its offices and what skills and organizational capacity is required at the district level. This paper reports on these changes, options facing the Government of Indonesia, and recommendations made by a World Bank team who worked on these issues with North Sumatra's Provincial Health Department.

Learning Objectives: At the end of this session, participants will 1. Know how provincial and district health services were organized prior to the introduction of recent legislation. 2. Understand the implications of recent legislation on the production of health services at the provincial and district levels. 3. Be familiar with proposals being put forth by a World Bank team for altering the way services are produced and delivered at the district level

Keywords: Health Service, Developing Countries

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Indonesia Department of Health, North Sumatra Provincial Health Department, Indonesian National Development Planning Body
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA